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Avinza (Generic Morphine)

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With repeated usage, morphine may develop a habit. Follow the morphine instructions exactly. Do not take it in larger amounts, more frequently, or otherwise differently than prescribed by your doctor. Discuss your pain management objectives, course of treatment, and additional pain management options with your healthcare provider while you are taking morphine. Inform your doctor if you or any family members regularly use significant amounts of alcohol, take street drugs, abuse prescription drugs excessively, experience overdosing, or currently suffer from depression or another mental disorder. If you currently have or have ever had any of these conditions, there is a higher chance that you may misuse morphine. If you believe that you may have an opioid addiction, call the U.S. or speak with your healthcare physician right away and ask for advice. Call the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-HELP.

During the first 24 to 72 hours of treatment and whenever your dose is raised, morphine may seriously or fatally impair your ability to breathe. Throughout your therapy, your doctor will keep a close eye on you. To manage your pain and lower your risk of developing severe breathing issues, your doctor will carefully modify your dosage. If you have asthma or slow breathing, let your doctor know. Your doctor might advise against taking morphine. Additionally, let your doctor know if you currently or ever had a lung condition like chronic obstructive pulmonary disease (COPD), a group of lung conditions that also includes chronic bronchitis and emphysema, a head injury, a brain tumour, or any other condition that raises the pressure inside of your head. If you’re an older adult, weak from a condition, or underweight, your risk of developing breathing issues may be higher. Call your doctor right away or get emergency medical attention if you have any of the following symptoms: slower breathing, protracted pauses between breaths, or shortness of breath.

While receiving morphine treatment, taking specific additional medications may raise your chance of developing breathing issues or other severe, life-threatening breathing issues, drowsiness, or coma. Inform your physician if you are currently taking or intend to take any of the following drugs: benzodiazepines such as alprazolam (Xanax), diazepam (Diastat, Valium), estazolam, flurazepam, lorazepam (Ativan), and triazolam (Halcion); cimetidine (Tagamet); other narcotic painkillers; drugs for mental illness or nausea; muscle relaxants; sed. Your doctor will closely monitor you and may need to adjust the dosage of your drugs. Call your doctor right away if you experience any of the following symptoms after taking morphine with any of these drugs: unusual dizziness, lightheadedness, excessive drowsiness, slowed or laboured breathing, or inability to respond. If you are unable to seek treatment on your own, make sure your caregiver or family members are aware of any symptoms that may be dangerous so they can contact the doctor or emergency services.

You have a higher chance of developing breathing issues or other severe, life-threatening adverse effects while receiving treatment with morphine if you consume alcohol, use prescription or over-the-counter drugs that do, or use illicit substances. It is crucial that you refrain from consuming any alcoholic beverages or taking any prescription or over-the-counter treatments that include alcohol while taking long-acting capsules under the Avinza brand. Alcohol may speed up the release of the morphine found in long-acting capsules under the Avinza® name, which could result in fatal side effects. During your course of therapy with other morphine products, refrain from drinking alcohol, taking any prescription or over-the-counter drugs that include alcohol, and using illicit substances.

Do not share your medication with anybody else. Those who take your medication with you, especially children, run the risk of being harmed or killed by morphine. So that no one else can take it intentionally or accidently, keep morphine in a secure location. Keep morphine out of the reach of youngsters at all costs. Keep track of how many tablets, capsules, or liquids are remaining so you can identify any missing medications. As directed, properly dispose of any unused morphine liquid, tablets, or capsules. (See DISPOSAL and STORAGE.)

The extended-release pills or capsules should be swallowed whole. Avoid breaking, chewing, dissolving, or crushing them. You might take too much morphine at once rather than gradually over time if you ingest extended-release tablets or capsules that have been chewed, crushed, chewed, or dissolved. Death or severe respiratory issues may result from this. If you are unable to take the capsules whole, go to the “HOW should this medication be used?” section for advice. To dissolve the capsule’s contents in applesauce, see the instruction below.

Three different strengths of liquid morphine oral solution are available (amount of medication contained in a given amount of solution). Only those who have become tolerant to the effects of opioid drugs should use the solution with the greatest concentration (100 mg/5 mL). Make sure the medication you receive each time is in the solution and concentration that your doctor has advised. Make sure you understand how to measure your dose and how much medication you should take.

If you are pregnant or want to become pregnant, let your doctor know. Regular morphine use during pregnancy increases the likelihood that your unborn child will have potentially fatal withdrawal symptoms. If your infant exhibits any of the following symptoms, contact your doctor straight away: irritability, hyperactivity, disturbed sleep, high-pitched crying, excessive shaking of a body part, vomiting, diarrhoea, or failure to gain weight.

If a Medication Guide is available for the morphine medication you are taking, your doctor or pharmacist will offer it to you when you start your treatment with the drug as well as each time you fill your prescription. If you have any questions, carefully read the material and contact your doctor or pharmacist. The Medication Guide is also available on the manufacturer’s website or the Food and Drug Administration (FDA) website.

Why is this medication prescribed?

For the relief of moderate to severe pain, morphine is administered. Only severe (24-hour) pain that is uncontrollable by the use of other painkillers is treated with morphine extended-release tablets and capsules. Pain that can be managed by medication taken as needed shouldn’t be treated with morphine extended-release tablets and capsules. The group of drugs known as opiate (narcotic) analgesics includes morphine. It functions by altering how the nerve system and brain react to pain.

How should this medicine be used?

There are three oral dosage forms of morphine: solution (liquid), extended-release (long-acting) tablet, and extended-release (long-acting) capsule. As needed for pain, the oral solution is typically given every four hours. Extended-release pills under the MS Contin and Arymo ER brands are often taken every 8 or 12 hours. Extended-release pills under the Morphabond name are typically taken every 12 hours. Extended-release capsules of the Kadian brand are typically taken with or without food every 12 or 24 hours. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following.

Use the dosage cup or syringe that comes with the medication to measure your dose if you’re taking morphine solution. Make sure you are aware of how many millilitres of the drink you need to consume. If you have any questions regarding how much medication to take or how to use the dosage cup or syringe, ask your pharmacist.

Ask your doctor or pharmacist how to deliver the medication through your gastrostomy tube if you use Kadian brand extended-release capsules and have a surgically implanted feeding tube.

If you are unable to take the extended-release capsules (Kadian), you can carefully open one, empty its contents onto a spoonful of cold or room-temperature applesauce, and then instantly swallow the entire mixture without chewing or crushing the beads. To ensure that you have ingested all of the medication, rinse your mouth with a little water and then swallow it. Never combine the beads with other foods. Avoid storing medication and applesauce concoctions for later.

Take the extended-release pills (Arymo ER) one at a time with lots of water if you’re taking them. As soon as you put the extended-release tablets in your mouth, swallow them. The extended-release pills shouldn’t be presoaked, moistened, or licked before being swallowed.

When your pain is under control, your doctor may put you on a low dose of morphine and gradually increase it. If your pain is not under control while you are receiving therapy, your doctor may change your dose at any time. Call your doctor if you believe that your pain is not being managed. Without first consulting your doctor, never alter the dosage of your prescription.

Without consulting your doctor, do not discontinue taking morphine. Your dose could be gradually reduced by your doctor. If you stop taking morphine abruptly, you might experience withdrawal symptoms like agitation, teary eyes, runny noses, yawning, irritability, anxiety, sweating, trouble falling or staying asleep, chills, back pain, muscle pain, joint pain, nausea, vomiting, loss of appetite, diarrhoea, stomach cramps, weakness, rapid heartbeat, or rapid breathing.

Other uses for this medicine

Ask your doctor or pharmacist for more details if you’re interested in using this drug for any other conditions.

What special precautions should I follow?

Before taking morphine,

  • If you have an allergy to morphine, any other drugs, or any of the inactive components in the kind of morphine product you want to use, let your doctor and pharmacist know right once. For a list of the inactive ingredients, consult the Medication Guide or speak with your pharmacist.
  • Inform your doctor and pharmacist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products that you are now taking or intend to use. Mention the drugs in the IMPORTANT WARNING section as well as any of the following: Antihistamines (found in cold and allergy medications); buprenorphine (Belbuca, Butrans, in Suboxone, among others); butorphanol; cyclobenzaprine (Amrix); dextromethorphan (found in many cough medications; in Nuedexta); diuretics (‘water pills’); lithium (Lithobid); medications for migraine headaches such as almotriptan (Axert), eletrip; Pentazocine (Talwin), quinidine (in Nuedexta), 5HT3 serotonin blockers like alosetron (Lotronex), dolasetron (Anzemet), granisetron (Kytril), ondansetron (Zofran, Zuplenz), or palonosetron (Aloxi), selective serotonin-reuptake inhibitors like fluoxetine (Prozac, Sarafem, in Symby (Surmontil). Additionally, let your doctor know if you’re using any of the monoamine oxidase (MAO) inhibitors listed below, or if you’ve recently stopped taking them: methylene blue, isocarboxazid (Marplan), linezolid (Zyvox), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate). Tell your doctor about all of the medications you are taking, even any not on this list, as many other drugs may also interact with morphine. Your physician might need to adjust the dosage of your drugs or keep a closer eye on you for adverse effects.
  • Tell your doctor about any herbal medications you are taking, notably tryptophan and St. John’s wort.
  • If you have paralytic ileus or any of the symptoms listed in the IMPORTANT WARNING section, let your doctor know very once (condition in which digested food does not move through the intestines). Your doctor might advise against taking morphine.
  • If you have or have ever had Addison’s disease (a condition in which the adrenal gland does not produce enough of certain natural substances), a blockage in your stomach or intestines, seizures, trouble swallowing, prostatic hypertrophy (enlargement of a male reproductive gland), urinary issues, low blood pressure, liver, kidney, pancreas, thyroid, or gallbladder disease, be sure to let your doctor know.
  • Tell your doctor if you are breastfeeding.
  • You should be aware that this medicine may lower both male and female fertility. The dangers of morphine use should be discussed with your doctor.
  • Inform the surgeon or dentist that you are taking morphine if you are having surgery, including dental surgery.
  • You should be aware that this medicine may cause you to feel sleepy. Prior to understanding how this drug affects you, avoid using machinery or driving a car.
  • You should be aware that morphine can make you feel weak, lightheaded, and dizzy if you stand up suddenly from a reclining position. Get out of bed gradually, resting your feet on the floor for a few minutes before standing up, to avoid this issue.
  • It’s important to be aware that morphine could cause constipation. While taking morphine, talk to your doctor about modifying your diet or using other medications to avoid or cure constipation.

What special dietary instructions should I follow?

Maintain your regular diet unless your doctor instructs you otherwise.

What should I do if I forget a dose?

If you are taking morphine pills or liquid, your doctor probably likely advise you to only take it as necessary.

If you have been directed to take planned doses of the tablets or liquid or if you are taking an extended-release product, take the missed dose as soon as you remember it, and do not take the next dose at your regularly scheduled time. Instead, wait the same length of time between dosages as you normally would before taking your next one. Skip the missed dose and carry on with your regular dosing plan if you realise when it is almost time for the subsequent dose. To make up for a missing dose, do not take a second one.

What side effects can this medication cause?

Morphine could have negative effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Drowsines
  • Constipation and cramps
  • Mouth dryness
  • Headache
  • Nervousness
  • Mood shifts
  • Small pupils (eyes with black circles in the middle)
  • Having trouble or experiencing discomfort when urinating

Some adverse effects can be very harmful. Call your doctor right away if you have any of the following symptoms:

  • Skin tone that is blue or purple
  • Alterations in heartbeat
  • Hallucinations (seeing or hearing objects or voices that aren’t there), agitation, sweating excessively, confusion, rapid heartbeat, shivering, extremely rigid or twitching muscles, loss of coordination, nausea, vomiting, or diarrhoea
  • Nausea, vomiting, lack of appetite, weakness, or dizziness
  • Failure to achieve or maintain erection
  • Abnormal menstruation
  • Reduced sexual arousal
  • Seizures
  • Extreme somnolence
  • Fainting
  • Chest pain
  • Fever
  • Hives
  • Rash
  • Itching
  • Eye, face, mouth, lips, or throat swelling
  • Hoarseness
  • Breathing or swallowing challenges

Other negative effects of morphine may occur. If you have any strange side effects while taking this medicine, contact your doctor right once.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication tightly closed in the original container and out of the reach of children. Store it away from excessive heat and moisture at room temperature (not in the bathroom). Any medication that has expired or is no longer needed must be disposed of right away via a medicine take-back programme. If there is no take-back programme nearby or one you can quickly access, flush any expired or no longer required morphine extended-release pills, extended-release capsules, and liquid down the toilet to prevent others from taking them. Consult your pharmacist for advice on how to properly dispose of your medications.

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

You should speak with your doctor about keeping a rescue drug called naloxone on hand while taking morphine (e.g., home, office). Naloxone is used to undo an overdose’s potentially fatal consequences. To treat harmful symptoms brought on by excessive levels of opiates in the blood, it functions by inhibiting the effects of opiates. If you live with young children or someone who has abused prescription or illicit drugs, your doctor could also advise you to get naloxone. Make sure you, your family, your caretakers, and anyone else who spends time with you are aware of the signs of an overdose, how to administer naloxone, and what to do until emergency assistance arrives.You and your family members will be shown how to use the medication by your doctor or pharmacist. For the directions, speak to your pharmacist or go to the manufacturer’s website. If you start to experience overdose symptoms, a friend or family member should administer the first dose of naloxone, contact 911 right away, and stay by your side while keeping a careful eye on you until emergency medical assistance comes. After receiving naloxone, your symptoms can come back a short while later. If your symptoms return, the person should give you another dose of naloxone. If symptoms reappear before receiving medical attention, more doses may be given every 2 to 3 minutes.

Overdose signs could include the following:

  • Uneven, shallow, or slow breathing
  • Having trouble breathing
  • Sleepiness
  • Unable to wake up or speak
  • Skeletal muscles
  • Clammy, frigid skin
  • Small eyes
  • Sluggish heartbeat
  • Distorted vision
  • Nausea
  • Fainting

What other information should I know?

Keep all of your appointments with your physician and the lab. To determine how your body reacts to morphine, your doctor may request specific lab tests.

Inform your doctor and the lab staff that you are taking morphine prior to any laboratory test (particularly one that uses methylene blue).

This medication cannot be renewed. Make sure to arrange meetings with your doctor if you often use morphine to manage your pain so that you never run out of the drug. If you are using morphine for a brief period of time, contact your doctor if your pain persists after the drug has worn off.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Arymo® ER
  • Avinza®
  • Kadian®
  • Morphabond®
  • MS Contin®
  • Oramorph® SR
  • Roxanol-T
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